A liver biopsy is a medical procedure that allows the doctor to take a small sample of the liver tissue to examine it for problems. To learn more about how and why a liver biopsy is done in children and what to expect before and after the procedure, download the GIKids Fact Sheet on Liver Biopsy.
What is a liver biopsy?
Liver biopsy is a procedure done to obtain a small sample of the liver. “Percutaneous” liver biopsy is accomplished with a special needle through the skin, leaving only a tiny scar. Occasionally it is best for a particular patient to have a liver biopsy done surgically instead.
Why does the child need a liver biopsy?
Although the doctor can find out a lot about the child’s liver condition with blood tests and imaging (like ultrasound), the liver biopsy can provide more exact information. The doctor can better find out what’s wrong with the child’s liver, and also how severe the problem is. The most common reasons to do a liver biopsy in babies and children are:
- Liver-related jaundice
- Liver inflammation (hepatitis)
- Abnormal liver-related blood tests
- An enlarged liver
- Possible rejection or infection in a transplanted liver
What is the preparation for a liver biopsy?
The doctor will order blood tests to measure the ability of the blood to clot normally. This will help minimize complications from the procedure, such as bleeding. Certain medications (including aspirin or ibuprofen) increase bleeding risk, so the child should not take these medications for several days prior to the biopsy, unless advised differently by the doctor. The child will need to fast for several hours so that safe sedation or anesthesia can be provided.
How is the procedure performed?
A liver biopsy is done in a hospital area where the child can be monitored carefully. An ultrasound may be done prior to help the doctor pick the best place for the biopsy. After sedation or anesthesia is given, the skin is cleansed and a needle is inserted through the skin and into the liver, then quickly withdrawn. This removes a tiny piece of liver tissue, which will be sent to the lab for examination under the microscope. After the procedure, the child is observed and monitored closely until it’s safe to go home. The time of discharge differs according to the age and health of the child and the reason for the biopsy, but is usually between 6 and 24 hours. Results are usually available in a day or two, later when special studies are needed.
What are the risks of a liver biopsy?
Liver needle biopsy is considered a safe procedure, but small risks include:
- Injury to another organ (lung, gallbladder)
- Sedation/anesthesia problems
- Persistent abdominal or chest pain
- Pale skin, weakness or dizziness
- Bleeding from the site of the biopsy
- Passage of tarry black stools
- Redness, tenderness and/or swelling at the biopsy site
- Difficulty breathing